• Title/Summary/Keyword: APRI

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Noninvasive markers for esophageal varices in children with cirrhosis

  • Rahmani, Parisa;Farahmand, Fatemeh;Heidari, Ghobad;Sayarifard, Azadeh
    • Clinical and Experimental Pediatrics
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    • v.64 no.1
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    • pp.31-36
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    • 2021
  • Background: The diagnosis of esophageal varices (EV) is based on the findings of esophagogastroduodenoscopy (EGD), biopsy, and serum markers. Thus, noninvasive cost-effective tests through which high-risk EV children can be diagnosed are needed. Purpose: This cross-sectional study aimed to identify the noninvasive markers for EV in children with liver cirrhosis. Methods: A total of 98 children with liver cirrhosis were evaluated in this study. The spleen size, platelet count, serum albumin, liver function test results, and risk scores were evaluated prior to endoscopy. The endoscopic investigations aimed to identify the presence of EV and red signs, and determine varices sizes. Results: Endoscopy revealed varices in 43 subjects (43.9%). The spleen size, platelet count, international normalized ratio, aspartate aminotransferase to platelet ratio index (APRI), platelet count to spleen size ratio, and risk score differed significantly between patients with and without EV on univariate analysis; however, the logistic regression analysis showed no differences, indicating that none of these parameters were independently associated with the presence of EV. Conclusion: Platelet count, risk score, platelet count to spleen size, and APRI can be useful tools for the identification of high-risk patients with EV and might reduce the need for invasive methods like EGD.

Analysis on Usefulness of Non-invasive Liver Fibrosis Evaluation Method according to the Liver Disease : Focused on Hepatitis C patients (간질환 종류에 따른 비침습적 간섬유화 평가법의 유용성 분석 : C형 간염 보균자 중심으로)

  • Nam, Ji-Hee;Kim, Jung-Hoon
    • Journal of radiological science and technology
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    • v.42 no.5
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    • pp.345-350
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    • 2019
  • Liver biopsy is the gold standard for diagnosing liver fibrosis, but it is invasive and has a risk for complications. For this reason, recently, study has been actively conducted on non-invasive liver fibrosis evaluation method. But, there is no established standard for the type of diffuse liver disease. Therefore, this study was suggest the usefulness and cut-off values of Fibroscan, FIB-4, APRI and AAR of patients with hepatitis C in Korea. According to the diagnosis, 240 people in hepatitis C are classified into fatty liver, chronic hepatitis, and liver cirrhosis. The statistical analysis was performed by ANOVA to verify difference between groups. The ROC curve was analyzed to determine the usefulness and practical cut-off value. As a result, for all diseases, the AUC value for Fibroscan was 0.8 over and the APRI was 0.7 over. Cut-off value of serum based liver fibrosis markers was increased in order of fatty liver, chronic hepatitis and liver cirrhosis. If Fibroscan and serological liver fibrosis markers are applied to predict liver fibrosis, it is expected that excessive liver biopsy can be reduced.

Experimental Studies on the Immunization Against Metastrongylus apri Infection with X-irradiated Infective Larvae (X 선조사감염자충(線照射感染仔蟲)에 의한 돈폐충증(豚肺蟲症)의 면역(免疫)에 관한 실험적연구(實驗的硏究))

  • Hyun-Beom, Lee
    • Korean Journal of Veterinary Research
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    • v.11 no.1
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    • pp.1-39
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    • 1971
  • The purpose of present study was to investigate the possibility to immunize guineapigs and swine against Metastrongylus apri infection by the administration of irradiated infective larvae. Four main experiments were undertaken. Firstly, three groups of infective larvae irradiated at $3{\times}10^4r$, $4{\times}10^4r$, and $5{\times}10^4r$ respectively were inoculated to guineapigs and their immunogenic effects were examined from the clinical, anatomical, and serological viewpoints to decide the optimal dose of X-ray for the atenuation of them. Secondly, the migratory behavior of the larvae irradiated at the optimal dose was compared with that of normal infective larvae. Thirdly, pigs were inoculated with each 5,000 infective larvae irradiated at the optimal dose and the clinical, anatomical and serological responses of them before and after challenge were examined. Fourthly, the heated extract of adult M. apri which had been used as an antigen in the serological examinations was analyzed and compared with that of adult Ascaris suis and of adult Trichuris suis by immunoelectrophoretic method. The results obtained are summerized as follows: 1) The optimal dose of X-ray for the atenuation of the infective larvae which can minimize the pathogenecity but keep the antigenecity of the infective larvae was $5{\times}10^4r$. 2) Guineapigs could become completely resistant to subsequent challenge infection by the administration of 1,000 infective larvae irradiated at $5{\times}10^4r$, without showing any symptom of disease before and after the challenge. 3) There were some indication that guineapigs could acquire complete immunity after they overcome the infection with normal infective larvae. 4) It was shown that, in guineapigs, the $5{\times}10^4r$-irradiated larvae can migrate to the large intestine and mesenteric lymph node within a day, where they stay for as long as 16 days to stimulate the host's immunity. 5) It also was shown that, in guineapigs, the normal infective larvae challenged to resistant guineapigs can migrate to the large intestine and mesenteric lymph node, where they are affected by the immune mechanism of host within 10 days without further migration. 6) Pigs could become partially resistant to subsequant challenge by the administration of 5,000 infective larve irradiated at $5{\times}10^4r$; no clinical symptom occurred after the administration, but milder symptoms of parasitic bronchitis were observable after the challenge infection and fewer number of worms were detected from the lungs at autopsy compared with severe symptoms and much number of worms in control pigs. 7) It was shown that, in pigs, a few of the $5{\times}10^4r$-irradiated larvae can migrate to the lungs, where they stay for as long as 104 days in stunted and sterile states; their body-lengths were short and their uteri developted no eggs. 8) There was evidence that the male larvae were more susceptible to X-ray than the female larvae. 9) Antibodies relating to the administration with $5{\times}10^4r$-irradiated or normal larvae were detected from the sera of both guineapigs and pigs by means of indirect haemagglutination and agar diffusion precipitin tests. Relatively higher antibody titers were recorded by the former test, but precipitin bands were demonstrable only when the positive sera were concentrated in one tenth of original volume in the later one. 10) The antibody titers of pig sera began to rose on 14 days, kept their peak during the period from 14 th day to 21st day, and fell to a low level on 28 days after the administration of $5{\times}10^4r$ or normal infective larvae. 11) A slight increase in gamma globublin of the pig sera occurred following the administration. The gamma globulin level showed a tendency to fluctuate in acordance with the antibody level. 12) A marked eosionophilia occurred in pigs on 7 or 14 days following the administration. The eosinophil count showed the same tendency to fluctuate as the gamma globulin did. 13) It was shown that the serum antibodies detected by the heated extract of adult Metastrongylus apri react crossly with the heated extract of adult Ascaris suis but not with that of adult Trichuris suis in indirect haemagglutination and agar diffusion preciption reactions. 14) The heated extract of adult Metastrongylus apri could he divided into 9 antigenic components by immunoelectrophoresis, one (arc 4) of which was shown to be common to both extracts of adult Ascaris suis and adult Trichuris suis, and the other one (arc 9) to only the extract of adult Ascaris suis.

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Diffusion-Weighted Imaging for Differentiation of Biliary Atresia and Grading of Hepatic Fibrosis in Infants with Cholestasis

  • Jisoo Kim;Hyun Joo Shin;Haesung Yoon;Seok Joo Han;Hong Koh;Myung-Joon Kim;Mi-Jung Lee
    • Korean Journal of Radiology
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    • v.22 no.2
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    • pp.253-262
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    • 2021
  • Objective: To determine whether the values of hepatic apparent diffusion coefficient (ADC) can differentiate biliary atresia (BA) from non-BA or be correlated with the grade of hepatic fibrosis in infants with cholestasis. Materials and Methods: This retrospective cohort study included infants who received liver MRI examinations to evaluate cholestasis from July 2009 to October 2017. Liver ADC, ADC ratio of liver/spleen, aspartate aminotransferase to platelet ratio index (APRI), and spleen size were compared between the BA and non-BA groups. The diagnostic performances of all parameters for significant fibrosis (F3-4) were obtained by receiver-operating characteristics (ROCs) curve analysis. Results: Altogether, 227 infants (98 males and 129 females, mean age = 57.2 ± 36.3 days) including 125 BA patients were analyzed. The absolute ADC difference between two reviewers was 0.10 mm2/s for both liver and spleen. Liver ADC value was specific (80.4%) and ADC ratio was sensitive (88.0%) for the diagnosis of BA with comparable performance. There were 33 patients with F0, 15 with F1, 71 with F2, 35 with F3, and 11 with F4. All four parameters of APRI (τ = 0.296), spleen size (τ = 0.312), liver ADC (τ = -0.206), and ADC ratio (τ = -0.288) showed significant correlation with fibrosis grade (all, p < 0.001). The cutoff values for significant fibrosis (F3-4) were 0.783 for APRI (area under the ROC curve [AUC], 0.721), 5.9 cm for spleen size (AUC, 0.719), 1.044 x 10-3 mm2/s for liver ADC (AUC, 0.673), and 1.22 for ADC ratio (AUC, 0.651). Conclusion: Liver ADC values and ADC ratio of liver/spleen showed limited additional diagnostic performance for differentiating BA from non-BA and predicting significant hepatic fibrosis in infants with cholestasis.

Study on the Characteristics of Chinese quince ( Chaenom-eles sinensis Koehne ) in the Southern Area of Korea (본과의 생육특성에 관한 연구)

  • 최성규
    • Korean Journal of Plant Resources
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    • v.2 no.2
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    • pp.306-311
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    • 1989
  • This study was carried out to investigates the growth characteristics of chinese quince (chaenomels sinensi KOEHNE) in the southernarea of Korea.The results obtained were summarized as folLows .Leaf deveLoping time ofchaenomels sinensi KOEHNE was in the lastof March .BlOoming time of chaenomels sinensis KOEHNE was in the middle ofApri1.Chinese quince B line matures on October 20, 9 days earlier thannon -grafted .Grafted chinese quince tree showed earlier fruiting than non-grufted chinese quince tree.

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Nonlinear Optical Fibers for Electro-optic Applications

  • Han, Won-Taek;Kim, Bok-Hyeon
    • Ceramist
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    • v.10 no.3
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    • pp.15-27
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    • 2007
  • Fabrication and electro-optic applications of glass optical fibers were reviewed. Theoretical description on the electro-optic Kerr effect in glass optical fibers, particularly for the second-order optical nonlinearity was given. Fabrication procedure and the characterization of the nonlinear electro-optic fibers with internal electrodes were described. Several electro-optic devices based on the polarimetric cells made by the nonlinear optical fibers with internal electrodes were also discussed with the experimental results on the electro-optic effect.

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Estimation and Comparison of Reference Crop Evapotranspiration at the Selected Stations in Korea (우리 나라 주요지점의 기준작물 증발산량 산정과 비교)

  • Kim Hyun-soo;Chung Sang-ok
    • KCID journal
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    • v.6 no.2
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    • pp.37-46
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    • 1999
  • This study is performed to select irrigation design year from 10-year return period 7-month(April to October) precipitation and compare reference crop evapotranspiration at 13 stations by REF-ET model. The three smallest 10-year return period 7-month(Apri

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The Clinical Significance of Serum Ferritin in Pediatric Non-Alcoholic Fatty Liver Disease

  • Na, Ji Hoon;Park, So Won;Kang, Yunkoo;Koh, Hong;Kim, Seung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.4
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    • pp.248-256
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    • 2014
  • Purpose: Non-alcoholic fatty liver disease (NAFLD) in children has become an important public health issue because of its high prevalence and severity. Several noninvasive methods for estimating NAFLD are under investigation. We aimed to evaluate the usefulness of serum ferritin as a biomarker of severity of pediatric NAFLD patients. Methods: A total of 64 NAFLD patient were enrolled from Severance Children's Hospital from March 2010 to February 2013. Serum ferritin levels, liver related laboratory tests, liver magnetic resonance imaging (MRI) (2-dimensional [2D] proton density-fat fraction) and NAFLD severity markers were compared between obese group and overweight group. Correlation analyses were performed between serum ferritin and laboratory values including NAFLD severity markers. Results: In obese group, serum ferritin, alanine aminotransferase (ALT), total bilirubin, international normalized ratio (INR), MRI 2D proton density-fat fraction, aspartate aminotransferase (AST) to platelet ratio index (APRI) and fibrosis- 4 (FIB-4) (an index score calculated from platelet count, ALT, AST and age) were significantly higher than those of overweight group. NAFLD severity markers, APRI and FIB-4, and liver specific important laboratory values, AST, ALT, INR, cholesterol, triglyceride and low density lipoprotein show significant correlation with serum ferritin in NAFLD patients. Conclusion: Serum ferritin concentrations could be a candidate of useful severity marker in the pediatric NAFLD patients.

Serologic Biomarkers for Hepatic Fibrosis in Obese Children with Nonalcoholic Steatohepatitis

  • Jung Yeon Joo;In Hyuk Yoo;Hye Ran Yang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.4
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    • pp.236-245
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    • 2024
  • Purpose: The prevalence of nonalcoholic steatohepatitis (NASH) is increasing with the increasing prevalence of childhood obesity. Although NASH has a high risk of progression to liver fibrosis and cirrhosis, few studies have reported noninvasive markers for predicting hepatic fibrosis in children. This study aimed to evaluate and compare the diagnostic accuracies of serologic biomarkers and scoring systems for hepatic fibrosis in obese children with NASH. Methods: A total of 96 children were diagnosed with NASH based on liver biopsy findings and divided into two groups according to the degree of liver fibrosis: mild (stage 0-1) or advanced (stage 2-4). Clinical and laboratory parameters and serum levels of hyaluronic acid and type IV collagen were measured. The aspartate aminotransferase/platelet ratio index (APRI) and fibrosis-4 (FIB-4) score were calculated. Results: Among the noninvasive markers, only serum type IV collagen level and FIB-4 were significantly different between the two groups. The area under the receiver operating curve of each biomarker and scoring system was 0.80 (95% confidence interval [CI]: 0.70-0.90) for type IV collagen at an optimal cutoff of 148 ng/mL (sensitivity 69.8%, specificity 84.6%), followed by 0.69 (95% CI: 0.57-0.83) for APRI, 0.68 (95% CI: 0.56-0.80) for FIB-4, and 0.65 (95% CI: 0.53-0.77) for hyaluronic acid. Conclusion: Type IV collagen as a single noninvasive serologic biomarker for hepatic fibrosis and FIB-4 as a hepatic fibrosis score are beneficial in predicting advanced hepatic fibrosis and determining proper diagnosis and treatment strategies before fibrosis progresses in obese children with NASH.